Saudi Journal of Gastroenterology
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Year : 2011  |  Volume : 17  |  Issue : 2  |  Page : 155-158

Carvedilol in the treatment of portal hypertension

Department of Hepatobiliary Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia

Correspondence Address:
Hamdan Al-Ghamdi
Department of Hepatobiliary Sciences, (IMB 1440), PO Box 22490, King Abdulaziz Medical City, Riyadh 11426
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.77251

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Variceal bleeding is a major event in the natural history of end-stage liver disease with a subsequent high mortality rate. Non-selective β-blockers are currently the drugs of choice for preventing first variceal bleeding. Endoscopic rubber band ligation of high risk varices features as a first line option if cirrhotic patients cannot tolerate β-blockers. Despite adequate β-blockade, some patients may still present with variceal bleeding. The effect of carvedilol, a non-selective β and α-1 receptor-blocker, on lowering portal pressure has been investigated in several clinical trials and found to be superior to propranolol in both acute and chronic hemodynamic studies. Recently, carvedilol has also been compared with band ligation for primary prophylaxis against variceal bleeding with equivalent results to band ligation. Patient tolerance to carvedilol in advanced liver disease remains a source of concern. This review examines the place of carvedilol as an alternative to the currently recommended pharmacological therapy in prophylaxis against variceal bleeding.

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